IMPORTANT STUFF HERE

Effective January 1, 2026, Sara is Out-of-Network

Insurance is less stressful when we understand the rules.

Insurance can be intimidating and confusing and frustrating.  No one should ever be caught unaware or surprised by a bill.  Everyone should be fully informed and have a complete understanding of their options and what they mean.  Sara is always very happy to set aside time to talk about and explain anything related to insurance, benefits, terminology, costs per visit, per month, per year, and answer any questions or address any concerns you may have.  Just ask! 

To use insurance or to not use insurance?

An individual may choose to be a “cash pay” client.  That means that they choose to pay for the full cost of services, out-of-pocket, without any reimbursement.  Why?  This is often for privacy reasons, but anyone has the right to choose to not utilize their insurance benefits if they don’t want to.  While there are legal and ethical limits related to confidentiality, an individual may not want others to have access to their psychotherapy records which may contain sensitive information about them.  One example may be that your insurance company has the right to obtain information from your chart if they are paying for your services.  Consider your privacy needs carefully. 

If you decide that you do not want to use your insurance, Sara is happy to discuss her rates with you.  If you have concerns about the costs of therapy with Sara, she is happy to discuss your options based on your needs; this may include a referral to another provider. 

Understanding your insurance:

When you use any medical services, according to the insurance plan you have, typically your insurance pays a portion of the overall cost and you are responsible to pay the difference; an amount referred to as a “deductible,” “co-insurance,” or “copay.”  Insurance often refers to this arrangement as “cost sharing.”  Every plan is different, even if obtained through the same source.  It’s very important that you understand how your plan is laid out and the details of your benefits. 

What is the difference between In Network and Out-of-Network?

Health insurance companies often have a network of doctors and hospitals that have agreed to provide services at reduced rates. These providers are known as “in-network” (INN).  For various reasons, some providers never enter into an agreement and some providers decide to terminate their agreement with insurance companies.  These providers are known as “out-of-network” (OON). 

Receiving care that is OON versus INN does not simply mean that you are 100% financially responsible for the cost of your care and that you can not recoup any portion of your costs.  Knowing and understanding your plan benefits is important. 

When you have a plan with OON benefits it actually means that you pay your provider directly at the time of service, your provider gives you the form necessary for you to be reimbursed by your insurance, you simply submit the form electronically, and you receive your reimbursement within a brief time.  The typical turnaround is about 2 weeks and you can have the funds directly deposited to your account of choice. 

How do your plan costs really differ?

In-Network (INN) Providers:

Example:  You have INN benefits, your provider is INN, and you have a $25 copay; you pay $25 “out-of-pocket" at the time of your visit.  *This example is just to illustrate the general idea, all plans are different. 

Out-of-Network (OON) Providers:

Example:  You have OON benefits with a 20% cost to you and 80% reimbursement.  You pay $150 or $175 at the time of your visit, your insurance reimburses you 80%, and your total “out-of-pocket” cost is $30 or $35, respectively.  *This example is just to illustrate the general idea, all plans are different. 

Know your insurance plan details:

Most insurance plans have a specific percentage reimbursement rate for OON.  If they don’t, you may have the option to choose a plan more suitable for your needs that includes OON benefits, usually during Open Enrollment which happens annually around October/November for employer plans, or before January 1st for Marketplace plans. 

How to File for Insurance Reimbursement After Your Therapy Session

Your therapist is no longer billing insurance directly. But you can still get reimbursed by your insurance provider if you have out-of-network mental health benefits. Here’s how to do it — step by step.

✅ Step 1: Check Your Out-of-Network Coverage

Before meeting with your therapist, call the number on the back of your insurance card (usually

under “Member Services”) and ask:

- “Do I have out-of-network mental health coverage?”

- “What is the reimbursement rate for out-of-network psychotherapy?”

- “Do I need to meet a deductible first?  And does it apply to mental health benefits?” 

- “Where do I send out-of-network claims?”

- “Do I need a special claim form?”  

Take notes and save this information.

✅ Step 2: Pay for Your Session

You’ll pay your therapist directly after each session. You’ll receive a Superbill (an itemized

invoice) that includes all the information your insurance company needs.

✅ Step 3: Fill Out a Claim Form (If Required In Addition to the Superbill)

Most insurance companies require a claim form, which you can usually download from their

website. Look for:

- “Out-of-Network Claim Form” or

- “Member Reimbursement Form”

Examples:

- Blue Cross Blue Shield: www.bcbs.com

- UnitedHealthcare: www.uhc.com

- Aetna: www.aetna.com

✅ Step 4: Gather Your Superbill

You’ll receive a Superbill from your therapist after each session. This is what you’ll send to

your insurance company.

Make sure it includes:

✔️ Your name and date of birth

✔️ Therapist’s name, license number, and NPI

✔️ Therapist’s address and phone number

✔️ Diagnosis code (ICD-10)

✔️ Procedure code (CPT — e.g., 90834 or 90837)

✔️ Date of service and session length

✔️ Total fee paid per session

✔️ Proof of payment (or a note saying “Paid in Full”)

If anything is missing, let your therapist know before submitting.

✅ Step 5: Submit Your Claim

Submit your claim form (if required) and Superbill to your insurance company.

You can usually submit it in one of three ways:

1) Upload online through your insurance member portal

2) Mail it to the claims address listed on your insurance card

3)Fax it (if listed as an option)

Keep a copy of everything you send!

✅ Step 6: Watch for Reimbursement

Your insurance will process your claim and (if approved) send you a check or apply the payment to your account. This usually takes 2–6 weeks, depending on the company. If you haven’t heard back in that time, follow up with their claims department.

Quick Tip:

You can often save time by submitting multiple sessions on one claim. Just make sure all the sessions are listed clearly on your Superbill.

Need Help?

If you’re unsure about any of the steps, reach out to your insurance company first. 

Cognitive Behavioral Therapy (CBT)

A type of talk therapy that focuses on how our thoughts, feelings, and behaviors are connected. The main idea behind CBT, is that our thoughts influence our feelings and our actions, and by changing negative or unhelpful thoughts or thought patterns, we can improve our feelings and behaviors.

Cognitive: The focus is on our thoughts; irrational or unhelpful thoughts versus rational or helpful thoughts. 

Behavioral: The focus is on our actions; how our actions are influenced by our thoughts and feelings. 

Cognitive Behavioral Therapy Process

Albert Ellis’ ABC Model (also ABCDE) illustrates CBT nicely: 

A: Activating Event (something happens to us or around us)

B: Belief (the Event causes us to have a Belief, either rational or irrational)

C: Consequence (the belief leads to a Consequence, with rational beliefs leading to healthy Consequences and irrational beliefs leading to unhealthy Consequences)

D: Disputation (if we have held an irrational belief which has caused unhealthy consequences, we must learn to Dispute the irrational in order to turn it rational)

E: Effect (the Disputation has turned the irrational Belief into a rational Belief; as a result we now have healthier Consequences because of our rational Belief)

Sometimes homework is given with CBT; for example, journaling thoughts or practicing skills learned in session, such as thought stopping or challenging irrational thoughts. Overall, CBT is practical and focused on helping individuals develop skills to better manage challenges, increase distress tolerance and improve overall mental wellbeing.

Mindfulness-Based Stress Reduction (MBSR) 

Is a program designed to help people manage stress and improve their well-being through mindfulness practices. 

Mindfulness: At its core, MBSR teaches mindfulness, which is defined as non-judgmental observation; observing your experience in the present moment without judging it or trying to modify it, to experience the moment as it is.

Structure: MBSR typically includes weekly group sessions, daily home practices, and guided meditations.

Stress Management: The primary goal of MBSR is to help individuals reduce stress and manage difficult emotions. By practicing mindfulness, people can become more aware of their stress triggers and learn to respond to them in a calmer, more balanced way.

Research-Based: MBSR is backed by scientific research showing its effectiveness in reducing symptoms of anxiety, depression, chronic pain, and other stress-related conditions.

Practical Applications: The skills learned in MBSR can be applied in everyday life, helping individuals handle challenges with greater resilience and awareness.

You can click the Resource button and find a video of guided meditation.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

Is a therapy modality designed to help individuals process and heal from traumatic experiences. Developed in the late 1980s by Dr Francine Shapiro, studies have shown that EMDR Therapy is particularly effective for those suffering from post-traumatic stress disorder (PTSD), but it can also help with anxiety, depression, and other emotional difficulties.

How Does EMDR Therapy Work?

EMDR Therapy utilizes a structured eight-phase protocol that includes:

History and Treatment Planning: The therapist gathers information about the client’s history and specific issues they want to address.

Preparation: The therapist explains the EMDR process and helps the client develop coping strategies to manage any distress that may arise.

Assessment: The client identifies specific traumatic memories to focus on during the therapy and the associated negative beliefs.

Desensitization: The client is guided to recall the traumatic memory while simultaneously engaging in bilateral stimulation, usually through guided eye movements. This helps reduce the emotional charge of the memory.

Installation: The therapist helps the client replace negative beliefs related to the trauma with more positive, empowering beliefs.

Body Scan: The client is encouraged to notice any physical tension related to the memory, allowing for further processing and release.

Closure: The session concludes with relaxation techniques, helping the client return to a state of calm.

Reevaluation: In subsequent sessions, the therapist and client review progress and address any remaining issues.

Benefits of EMDR Therapy

Rapid Processing: Many clients experience significant relief after just a few sessions.

Holistic Approach: EMDR addresses both the emotional and physical responses to trauma.

Empowerment: Clients often report feeling more in control and resilient after therapy.

Is EMDR Therapy Right for You?

If you’re struggling with trauma, anxiety, or negative beliefs, EMDR Therapy may be a beneficial option.  It's important to consult with a reputably trained EMDR Therapy provider who can guide you through the process in a safe and supportive environment. 

Important EMDR Therapy Resources

If you are interested in more information, please see the links below.

EMDRIA.org

emdr.com